The Aged Care Standards and Accreditation Agency Ltd
Accreditation, Quality and Reasons for failure
Mark Brandon
August 2008
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Overview
The Aged Care Standards and Accreditation Agency Ltd
Part 1 Mark Brandon Context Compliance outcomes 2000-2008 The evaluation of accreditation Part 2 Ross Bushrod Creators of risk of non compliance Reasons for non compliance
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Residential aged care
The Aged Care Standards and Accreditation Agency Ltd
170,000 residential aged care places 1,600 providers 2850 homes Religious Community/charity Government Private 29% 33% 12% 27%
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Residential aged care
The Aged Care Standards and Accreditation Agency Ltd
156,600 residents 27% born overseas (11% UK and Ireland)
70% high care 54% >85 yrs 27% > 90 yrs ALOS 146 weeks female 167 weeks male 110 weeks
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Accreditation
The Aged Care Standards and Accreditation Agency Ltd
Dual purpose
Stimulate improvement Assure compliance with Standards
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Accreditation Standards
The Aged Care Standards and Accreditation Agency Ltd
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Accreditation Standards
The Aged Care Standards and Accreditation Agency Ltd
Management systems Health and Personal care Resident lifestyle Physical environment and safe system
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Accreditation Scores
The Aged Care Standards and Accreditation Agency Ltd
Round 1 (2000) Round 2 (2003) Round 3 (2006)
64% 88% 92%
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Accreditation Scores
The Aged Care Standards and Accreditation Agency Ltd
Homes by location (44/44) Major cities Inner regional Outer regional Remote Very remote 93% 92% 88% 87% 71%
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Non compliance
The Aged Care Standards and Accreditation Agency Ltd
Continuous improvement Information systems Clinical care Medication management Human resource management Behavioural management
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Evaluation of Accreditation
The Aged Care Standards and Accreditation Agency Ltd
Campbell Report – approach Released mid 2008 Literature review Comparative regulatory systems Qualitative research previous work benchmarks Stakeholder consultations Baseline data
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Key findings (stakeholders)
The Aged Care Standards and Accreditation Agency Ltd
Accreditation => positive impact
Quality has improved since 1997
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Key findings (stakeholders)
The Aged Care Standards and Accreditation Agency Ltd
Accreditation => positive impact
Quality has improved since 1997 Accreditation accepted as part of regulatory framework Absence of industry quality indicators Baseline Compare individual home changes Measure industry improvement
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Accreditation has
The Aged Care Standards and Accreditation Agency Ltd
Removed underperforming homes
Set minimum standard Raised the standard of quality Established a degree of consistency Focus on improvement Focus on resident
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Impact of accreditation
The Aged Care Standards and Accreditation Agency Ltd
Role
Very positive 50%
Somewhat positive 38%
Quality mgrs
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Impact of accreditation
The Aged Care Standards and Accreditation Agency Ltd
Role
Very positive 50% 19%
Somewhat positive 38% 67%
Quality mgrs Care staff
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Impact of accreditation
The Aged Care Standards and Accreditation Agency Ltd
Role
Very positive 50% 19% 31%
Somewhat positive 38% 67% 56%
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Quality managers Care staff Families
Contributing factors
The Aged Care Standards and Accreditation Agency Ltd
Managers > 10 years Accreditation (68%) Staff training (43%) Regulation (36%)
Staff > 10 years Accreditation (48%) Staff training (38%) Regulation (23%)
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Other contributing factors
The Aged Care Standards and Accreditation Agency Ltd
Managers > 10 years Resident focus Understanding of quality Management structures Newer buildings Community expectations
Staff > 10 years Improved facilities Focus on quality Clinical health Resident focus Consumer demand
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Quality
The Aged Care Standards and Accreditation Agency Ltd
Quality of care - v - quality of life Care Life health status/medical model individuals unique experience v expectation
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Quality
The Aged Care Standards and Accreditation Agency Ltd
Quality of care - v - quality of life
Care Life health status/medical model individuals unique experience v expectation
Quality of care is subset of quality of life
Relationship changes over time
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How to measure quality?
The Aged Care Standards and Accreditation Agency Ltd
Quality in the accreditation context Quality measures for individuals? Individuals expectations v accreditation standards Facility quality means? Quality indicators?
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Self rated
The Aged Care Standards and Accreditation Agency Ltd
Overall quality
Role Quality manager Family/resident Care staff Excellent 35% 35% 19% Very good 58% 35% 47%
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Self rated
The Aged Care Standards and Accreditation Agency Ltd
Clinical (overall)
Role Quality manager Family/resident Care staff Excellent 64% (35%) 29% (35%) 29% (19%) Very good 31% (58%) 38% (35%) 45% (47%)
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Self rated
The Aged Care Standards and Accreditation Agency Ltd
Life (overall)
Role Quality manager Family/resident Care staff Excellent 45% (35%) 21% (35%) 16% (19%) Very good 45% (58%) 33% (35%) 42% (47%)
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Self rated
The Aged Care Standards and Accreditation Agency Ltd
Clinical, Life, Overall
Role Excellent Very good 31% 45% 58%
Quality manager 64% 45% 35%
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Self rated
The Aged Care Standards and Accreditation Agency Ltd
Clinical, Life, Overall
Role Excellent Very good 31% 45% 58% 38% 33% 35%
Quality manager 64% 45% 35% Family/resident 29% 21% 35%
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Self rated
The Aged Care Standards and Accreditation Agency Ltd
Clinical, Life, Overall
Role Excellent Very good 31% 45% 58% 38% 33% 35% 45% 42% 47%
Quality manager 64% 45% 35% Family/resident 29% 21% 35% Care staff 29% 16% 19%
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Other ‘findings’
The Aged Care Standards and Accreditation Agency Ltd
Administrative effort to achieve accreditation documentation Preparing for accreditation Range of understanding of accreditation Staff satisfaction with accreditation Expectations of the accrediting body Community expectations Has accreditation added to the costs?
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Summary
The Aged Care Standards and Accreditation Agency Ltd
The introduction of the Aged Care Act 1997 has driven improvement in the residential aged care sector Accreditation has been the significant driver Other regulation Community expectations Care standards Monitoring
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Next steps
The Aged Care Standards and Accreditation Agency Ltd
Minister Initiated discussions about process and Standards Strengthen accreditation processes Strengthen monitoring Promote quality improvement
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The Aged Care Standards and Accreditation Agency Ltd
THANK YOU
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